A comparison of islet autotransplantation with allotransplantation and factors elevating acute portal pressure in clinical islet transplantation

Background Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal...

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Published in	Journal of hepato-biliary-pancreatic sciences Vol. 19; no. 3; pp. 281 - 288
Main Authors	Kawahara, Toshiyasu, Kin, Tatsuya, Shapiro, A.M. James
Format	Journal Article
Language	English
Published	Japan Blackwell Publishing Ltd 01.05.2012 Springer Japan Wiley Subscription Services, Inc
Subjects	Abdominal Surgery clinical islet transplantation Diabetes Mellitus, Type 1 - surgery Follow-Up Studies Gastroenterology Hepatology Humans Hypertension, Portal - etiology Hypertension, Portal - physiopathology Injections, Intravenous Islets of Langerhans Transplantation - adverse effects Islets of Langerhans Transplantation - methods Liver cirrhosis Medicine Medicine & Public Health Original Article Portal Pressure Portal Vein portal vein thrombosis portal venous pressure Portography Postoperative Complications Retrospective Studies Risk Factors Surgical Oncology Transplantation, Autologous Transplantation, Homologous Transplants & implants Venous Thrombosis - complications Venous Thrombosis - diagnostic imaging Venous Thrombosis - physiopathology Portal venous pressure Clinical islet transplantation Portal vein thrombosis
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ISSN	1868-6974 1868-6982 1868-6982
DOI	10.1007/s00534-011-0441-2

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Abstract	Background Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal vein thrombosis. Methods Retrospective data was collected on 15 islet autotransplant and 122 allogeneic islet transplant subjects. Non-purified pancreatic cells were transplanted in islet autotransplants, and purified islet cells were transplanted in allogeneic transplants. Portal pressure was documented throughout the islet infusion. Results The total numbers of transplanted islets were significantly smaller in autotransplants than allografts, although the packed cell volume in autotransplants was larger. Autoislet infusion, with a larger packed cell volume, caused higher transient portal venous pressures than allogeneic islet transplant. Univariate analysis and multivariate linear regression revealed that packed cell volume and the number of transplanted cells were significant risk factors for acute portal pressure rise in both autotransplants and allogeneic transplants. Conclusions Non-purified IAT has a higher risk for acute portal pressure rise than allogeneic islet transplantation, and the rise is associated with the packed cell volume and the number of transplanted cells. Minimization of packed cell volume and cautious monitoring of portal pressure are important to avoid potential complications of portal hypertension.
AbstractList	Background Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal vein thrombosis. Methods Retrospective data was collected on 15 islet autotransplant and 122 allogeneic islet transplant subjects. Non‐purified pancreatic cells were transplanted in islet autotransplants, and purified islet cells were transplanted in allogeneic transplants. Portal pressure was documented throughout the islet infusion. Results The total numbers of transplanted islets were significantly smaller in autotransplants than allografts, although the packed cell volume in autotransplants was larger. Autoislet infusion, with a larger packed cell volume, caused higher transient portal venous pressures than allogeneic islet transplant. Univariate analysis and multivariate linear regression revealed that packed cell volume and the number of transplanted cells were significant risk factors for acute portal pressure rise in both autotransplants and allogeneic transplants. Conclusions Non‐purified IAT has a higher risk for acute portal pressure rise than allogeneic islet transplantation, and the rise is associated with the packed cell volume and the number of transplanted cells. Minimization of packed cell volume and cautious monitoring of portal pressure are important to avoid potential complications of portal hypertension. Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal vein thrombosis.BACKGROUNDAcute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal vein thrombosis.Retrospective data was collected on 15 islet autotransplant and 122 allogeneic islet transplant subjects. Non-purified pancreatic cells were transplanted in islet autotransplants, and purified islet cells were transplanted in allogeneic transplants. Portal pressure was documented throughout the islet infusion.METHODSRetrospective data was collected on 15 islet autotransplant and 122 allogeneic islet transplant subjects. Non-purified pancreatic cells were transplanted in islet autotransplants, and purified islet cells were transplanted in allogeneic transplants. Portal pressure was documented throughout the islet infusion.The total numbers of transplanted islets were significantly smaller in autotransplants than allografts, although the packed cell volume in autotransplants was larger. Autoislet infusion, with a larger packed cell volume, caused higher transient portal venous pressures than allogeneic islet transplant. Univariate analysis and multivariate linear regression revealed that packed cell volume and the number of transplanted cells were significant risk factors for acute portal pressure rise in both autotransplants and allogeneic transplants.RESULTSThe total numbers of transplanted islets were significantly smaller in autotransplants than allografts, although the packed cell volume in autotransplants was larger. Autoislet infusion, with a larger packed cell volume, caused higher transient portal venous pressures than allogeneic islet transplant. Univariate analysis and multivariate linear regression revealed that packed cell volume and the number of transplanted cells were significant risk factors for acute portal pressure rise in both autotransplants and allogeneic transplants.Non-purified IAT has a higher risk for acute portal pressure rise than allogeneic islet transplantation, and the rise is associated with the packed cell volume and the number of transplanted cells. Minimization of packed cell volume and cautious monitoring of portal pressure are important to avoid potential complications of portal hypertension.CONCLUSIONSNon-purified IAT has a higher risk for acute portal pressure rise than allogeneic islet transplantation, and the rise is associated with the packed cell volume and the number of transplanted cells. Minimization of packed cell volume and cautious monitoring of portal pressure are important to avoid potential complications of portal hypertension. Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal vein thrombosis. Retrospective data was collected on 15 islet autotransplant and 122 allogeneic islet transplant subjects. Non-purified pancreatic cells were transplanted in islet autotransplants, and purified islet cells were transplanted in allogeneic transplants. Portal pressure was documented throughout the islet infusion. The total numbers of transplanted islets were significantly smaller in autotransplants than allografts, although the packed cell volume in autotransplants was larger. Autoislet infusion, with a larger packed cell volume, caused higher transient portal venous pressures than allogeneic islet transplant. Univariate analysis and multivariate linear regression revealed that packed cell volume and the number of transplanted cells were significant risk factors for acute portal pressure rise in both autotransplants and allogeneic transplants. Non-purified IAT has a higher risk for acute portal pressure rise than allogeneic islet transplantation, and the rise is associated with the packed cell volume and the number of transplanted cells. Minimization of packed cell volume and cautious monitoring of portal pressure are important to avoid potential complications of portal hypertension. Background Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal vein thrombosis. Methods Retrospective data was collected on 15 islet autotransplant and 122 allogeneic islet transplant subjects. Non-purified pancreatic cells were transplanted in islet autotransplants, and purified islet cells were transplanted in allogeneic transplants. Portal pressure was documented throughout the islet infusion. Results The total numbers of transplanted islets were significantly smaller in autotransplants than allografts, although the packed cell volume in autotransplants was larger. Autoislet infusion, with a larger packed cell volume, caused higher transient portal venous pressures than allogeneic islet transplant. Univariate analysis and multivariate linear regression revealed that packed cell volume and the number of transplanted cells were significant risk factors for acute portal pressure rise in both autotransplants and allogeneic transplants. Conclusions Non-purified IAT has a higher risk for acute portal pressure rise than allogeneic islet transplantation, and the rise is associated with the packed cell volume and the number of transplanted cells. Minimization of packed cell volume and cautious monitoring of portal pressure are important to avoid potential complications of portal hypertension.
Author	Kawahara, Toshiyasu Kin, Tatsuya Shapiro, A.M. James
Author_xml	– sequence: 1 givenname: Toshiyasu surname: Kawahara fullname: Kawahara, Toshiyasu email: kawahara@juntendo.ac.jp organization: Department of Surgery, University of Alberta, 2D4.44 Walter C. Mackenzie Centre, AB, T6G 2B7, Edmonton, Canada – sequence: 2 givenname: Tatsuya surname: Kin fullname: Kin, Tatsuya organization: Department of Surgery, University of Alberta, 2D4.44 Walter C. Mackenzie Centre, AB, T6G 2B7, Edmonton, Canada – sequence: 3 givenname: A.M. James surname: Shapiro fullname: Shapiro, A.M. James organization: Department of Surgery, University of Alberta, 2D4.44 Walter C. Mackenzie Centre, AB, T6G 2B7, Edmonton, Canada
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Blondet, Carlson, Kobayashi, Jie, Bellin, Hering (CR10) 2007; 87 Mehigan, Bell, Zuidema, Eggleston, Cameron (CR14) 1980; 191 Ryan, Paty, Senior, Shapiro (CR13) 2004; 4 Wahoff, Papalois, Najarian, Kendall, Farney, Leone (CR32) 1995; 222 Kin (CR22) 2010; 654 Walsh, Eggleston, Cameron (CR17) 1982; 91 Mosteller (CR23) 1987; 317 Cameron, Mehigan, Broe, Zuidema (CR19) 1981; 193 Osama Gaber, Chamsuddin, Fraga, Fisher, Lo (CR5) 2004; 77 Hering, Kandaswamy, Ansite, Eckman, Nakano, Sawada (CR2) 2005; 293 Memsic, Busuttil, Traverso (CR15) 1984; 95 Sutherland, Matas, Najarian (CR9) 1978; 58 Ricordi, Strom (CR1) 2004; 4 Hirshberg, Rother, Digon, Lee, Gaglia, Hines (CR29) 2003; 26 Moberg, Johansson, Lukinius, Berne, Foss, Källen (CR20) 2002; 360 Johansson, Lukinius, Moberg, Lundgren, Berne, Foss (CR21) 2005; 54 Casey, Lakey, Ryan, Paty, Owen, O’Kelly (CR30) 2002; 74 Gores, Sutherland (CR31) 1993; 166 Linetsky, Bottino, Lehmann, Alejandro, Inverardi, Ricordi (CR25) 1997; 46 Shapiro, Lakey, Ryan, Korbutt, Toth, Warnock (CR4) 2000; 343 Weimar, Rauber, Brendel, Bretzel, Rau (CR8) 1999; 22 Anazawa, Balamurugan, Bellin, Zhang, Matsumoto, Yonekawa (CR33) 2009; 9 Goss, Soltes, Goodpastor, Barth, Lam, Brunicardi (CR7) 2003; 76 Toledo-Pereyra, Rowlett, Cain, Rosenberg, Gordon, MacKenzie (CR16) 1984; 38 Willett, Dietz, Colditz (CR24) 1999; 341 Ahmad, Lowy, Wray, D’Alessio, Choe, James (CR11) 2005; 201 Merani, Toso, Emamaullee, Shapiro (CR26) 2008; 95 Shapiro, Lakey, Rajotte, Warnock, Friedlich, Jewell (CR18) 1995; 59 Owen, Ryan, O’Kelly, Lakey, McCarthy, Paty (CR6) 2003; 229 Sutherland, Gruessner, Carlson, Blondet, Balamurugan, Reigstad (CR12) 2008; 86 Villiger, Ryan, Owen, O’Kelly, Oberholzer, Saif (CR28) 2005; 5 Bellin, Kandaswamy, Parkey, Zhang, Liu, Ihm (CR3) 2008; 8 Yin, Ding, Shen, Ma, Hara, Chong (CR27) 2006; 6 2005; 293 2002; 74 1995; 59 1997; 46 2004; 4 1999; 341 1999; 22 2008; 8 2006; 6 1980; 191 1978; 58 2008; 95 2003; 76 1993; 166 1981; 193 2004; 77 1984; 95 2003; 229 1984; 38 2002; 360 2005; 201 2010; 654 1987; 317 2005; 5 2003; 26 2009; 9 2005; 54 2000; 343 2008; 86 1982; 91 1995; 222 2007; 87 e_1_2_8_28_1 e_1_2_8_29_1 e_1_2_8_24_1 Linetsky E (e_1_2_8_26_1) 1997; 46 e_1_2_8_25_1 e_1_2_8_27_1 e_1_2_8_3_1 e_1_2_8_2_1 e_1_2_8_5_1 e_1_2_8_4_1 e_1_2_8_7_1 Sutherland D (e_1_2_8_10_1) 1978; 58 e_1_2_8_6_1 e_1_2_8_9_1 e_1_2_8_8_1 e_1_2_8_20_1 e_1_2_8_21_1 e_1_2_8_22_1 e_1_2_8_23_1 e_1_2_8_17_1 e_1_2_8_19_1 e_1_2_8_13_1 e_1_2_8_14_1 e_1_2_8_15_1 e_1_2_8_32_1 Walsh T (e_1_2_8_18_1) 1982; 91 e_1_2_8_31_1 e_1_2_8_11_1 e_1_2_8_34_1 e_1_2_8_12_1 Memsic L (e_1_2_8_16_1) 1984; 95 e_1_2_8_33_1 e_1_2_8_30_1
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Snippet	Background Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue... Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification... Background Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue...
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SubjectTerms	Abdominal Surgery clinical islet transplantation Diabetes Mellitus, Type 1 - surgery Follow-Up Studies Gastroenterology Hepatology Humans Hypertension, Portal - etiology Hypertension, Portal - physiopathology Injections, Intravenous Islets of Langerhans Transplantation - adverse effects Islets of Langerhans Transplantation - methods Liver cirrhosis Medicine Medicine & Public Health Original Article Portal Pressure Portal Vein portal vein thrombosis portal venous pressure Portography Postoperative Complications Retrospective Studies Risk Factors Surgical Oncology Transplantation, Autologous Transplantation, Homologous Transplants & implants Venous Thrombosis - complications Venous Thrombosis - diagnostic imaging Venous Thrombosis - physiopathology
Title	A comparison of islet autotransplantation with allotransplantation and factors elevating acute portal pressure in clinical islet transplantation
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